Provider Demographics
NPI:1265320162
Name:RIVERA, FELICIA
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:BARSTOW
Mailing Address - State:CA
Mailing Address - Zip Code:92311-5444
Mailing Address - Country:US
Mailing Address - Phone:626-607-8351
Mailing Address - Fax:626-607-8351
Practice Address - Street 1:309 FOREST AVE
Practice Address - Street 2:
Practice Address - City:BARSTOW
Practice Address - State:CA
Practice Address - Zip Code:92311-5444
Practice Address - Country:US
Practice Address - Phone:626-607-8351
Practice Address - Fax:626-607-8351
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider